Castration-Sensitive and Nonmetastatic CRPC Clinical Challenge
Reviewed by: HU Medical Review Board | Last reviewed: October 2026 | Last updated: October 2026
Many advanced prostate cancer decisions happen before the disease is metastatic and castration-resistant. These 5 questions test current guidance on nonmetastatic castration-resistant prostate cancer (nmCRPC) and metastatic castration-sensitive prostate cancer (mCSPC), from defining castration resistance to monitoring treatment.
Clinical Challenge
The American Urological Association/Society of Urologic Oncology (AUA/SUO) guideline defines castration-resistant prostate cancer as progression despite androgen deprivation therapy (ADT) and a testosterone level below what threshold?
Clinical Challenge
In nmCRPC, which PSA doubling time (PSADT) does AUA/SUO use to identify patients at high risk who should be offered an androgen receptor pathway inhibitor (ARPI) with continued ADT?
Clinical Challenge
A 64-year-old man has newly diagnosed, high-volume, de novo mCSPC. He has no major comorbidities and is fit for chemotherapy. Which approach does AUA/SUO support?
Clinical Challenge
How often does AUA/SUO recommend imaging high risk patients with nmCRPC to detect metastatic disease?
Clinical Challenge
When a patient starts abiraterone plus prednisone, how often does the prescribing information advise monitoring blood pressure, serum potassium, and fluid retention symptoms?